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Year : 1998  |  Volume : 46  |  Issue : 2  |  Page : 109--114

Role of intracranial pressure monitoring in head injury : a prospective study.


Department of Neurosurgery, All Institute of Medical Sciences, New Delhi - 110 029, India

Correspondence Address:
AK Mahapatra
Department of Neurosurgery, All Institute of Medical Sciences, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


PMID: 29508797

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Intra-cranial pressure (ICP) monitoring was carried out in 51 patients with head injury, admitted to the intensive care unit of All India Institute of Medical Sciences for a minimum of 24 hours. 74 patients with mass lesion and 33 patients without mass lesion had raised ICP (<15 mm of Hg). CT scan was not always reflective of ICP status. ICP monitoring helped in avoiding unnecessary mannitol therapy in 8 out of 12 patients without mass lesion. In this group presence or absence of raised ICP did not affect the outcome. Among 21 patients with mass lesions initially managed conservatively, 3 were operated upon on the basis of raised ICP alone. Four patients with good Glasgow Coma Sclae (GCS) (11-14), who had raised ICP were operated after clinical deterioration. However, in these patients raised ICP preceded clinical deterioration by 8-12 hours. In electively ventilated patients, raised ICP guided early repeat scan and early detection of postoperative haematomas. Patients with mass lesionand increasing ICP had poor outcome, overall mortality being 41. Among them 48 died due to raised ICP. Damped tracings or blockage of device were the most common complication of ICP monitoring. This complication was recorded in 25 of cases in whom Richmond screw was used and 12 of cases in whom intra-cavitary catheter was used. Six percent cases developed meningitis.






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